The Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

AR3653 Issued in AR

Legal business name

THE SURGERY CENTER, LLC

Doing business as

The Surgical Pavilion, LLC

Practice address

9500 Kanis Rd
Suite 401
Little Rock, AR 72205-6324

Phone

(501) 227-9088

Fax

(501) 219-3630

NPI assigned

Apr 27, 2006

Last updated

Feb 22, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pamela Hooper

Title

Administrator

Phone

(501) 227-9088

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Surgical Pavilion, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Listed as

The Surgical Pavilion LLCCCN 04C0001043

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266796800000",
    "number": "1245297829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD",
            "address_2": "SUITE 401",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056324",
            "telephone_number": "501-227-9088",
            "fax_number": "501-219-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 KANIS RD",
            "address_2": "SUITE 401",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056324",
            "telephone_number": "501-227-9088",
            "fax_number": "501-219-3630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-02-22",
        "status": "A",
        "authorized_official_last_name": "HOOPER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-227-9088"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AR",
            "license": "AR3653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136078128",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Surgical Pavilion, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Ambulatory Surgical Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.